Timberline et al reported a scoring tool for evaluating the severity of Persistent Pulmonary Hypertension of newborn (PPHN). This has 2 components, one based on oxygenation and one for echocardiographic findings. The authors are from the University of Virginia and University of California Davis.
Patient selection: persistent pulmonary hypertension of newborn (PPHN)
HRF = hypoxemic respiratory failure
PH = pulmonary hypertension
Parameters for echocardiogram score:
(1) interventricular septal position (IVSP score)
(2) estimated right ventricular systolic pressure (if unavailable use IVSP score)
(3) tricuspid annular plane systolic excursion (TAPSE) in mm (if unavailable use IVSP score)
(4) right ventricular diastolic dysfunction
|
Parameter
|
Finding
|
Points
|
|
IVSP
|
bulging right
|
0
|
|
|
slightly bulging right; intermittently midline
|
1
|
|
|
mostly midline; severely flattened or flattened throughout
|
2
|
|
|
bulging left
|
3
|
|
right ventricular systolic pressure
|
< 0.5 * (systemic)
|
0
|
|
|
0.5 to 0.66 * (systemic)
|
1
|
|
|
0.67 to 1.0 * (systemic)
|
2
|
|
|
> systemic
|
3
|
|
TAPSE
|
>= 8 mm
|
0
|
|
|
5 to 7.9 mm
|
1
|
|
|
2 to 4.9 mm
|
2
|
|
|
< 2 mm
|
3
|
|
right ventricular diastolic dysfunction
|
no
|
0
|
|
|
yes
|
1
|
echocardiogram score =
= SUM(points for all of the parameters)
total HRF/PH score =
= (oxygenation score) + (echocardiogram score)
Interpretation:
• minimum echocardiogram score: 0
• maximum echocardiogram: 10
• minimum total score: 0
• maximum total score: 15
|
Total HRF/PH
|
Severity of PPHN
|
|
0 to 5
|
mild
|
|
6 to 10
|
moderate
|
|
11 to 15
|
severe
|
